Active NPI
Shannon McCormick, PHARMD
- Pharmacist
- West Sand Lake, NY
National Provider Identifier
1962008862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065791
- Practice address
- 3703 Ny 43
West Sand Lake, NY 12196 - Phone
- (518) 674-3475
- NPI assigned
- Dec 7, 2020
- Last updated
- Mar 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 065791 | NY | Primary |
Addresses
Primary practice location
3703 Ny 43
West Sand Lake, NY 12196
Mailing address
PO Box 479
Rensselaer, NY 12144-0479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 065791 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin's Foods of South Burlington, LLC | Past | Accepting new patients | |
| Martins Foods of South Burlington LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Hannaford Supermarket & Pharmacy
- Community/Retail Pharmacy
- Troy, NY
- NPI 1306574215
-
dba Hannaford Supermarket & Pharmacy
- Community/Retail Pharmacy
- West Sand Lake, NY
- NPI 1407122922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1962008862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 479",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121440479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3703 NY 43",
"city": "WEST SAND LAKE",
"state": "NY",
"postal_code": "12196",
"telephone_number": "518-674-3475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2023-03-22",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Sand Lake, NY
- Jan Pedersen
- Christa Grace Kearsey
- Linda Lombardi
- Christina Malone, M.S., C.C.C.
- Martins Foods of South Burlington LLC (Hannaford Supermarket & Pharmacy)
- Montefiore Medical Center
- Kimberly Mousseau-Young, IBCLC
- Lauren Nunziato, OTR/L
- Jan Pedersen, BOCO ORTHOTIST
- Physical Therapy Associates of Schenectady, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.